Method and apparatus for determining malposition of vertebrae



Dec. 5, 195a 2,532,915

H. J. HORNER METHOD AND APPARATUS FOR DETERMINING MALPOSITION OF VERTEBRAE Filed Jan. 11, 1949 a 56 "00 ac ATTOE/VE Y5 Patented Dec. 5, 1950 UNITED STATES PATENT OFFICE METHOD AND APPARATUS FOR DETERMIN- ING M'ALPOSITION OF VERTEBRAE Herbert J. Homer, Dayton, Ohio Application January 11, 1949, Serial No. 70,278

28 Claims. 1

This invention relates to a method and. apparatus for determining malposition or incorrect position of the osseous or bonelikc tissue of the human spinal column and pelvis by means of vibration, to render it possible to accurately determine any malposition. of the pelvis or of vertebrae under investigation.

It is well known that malposition cf vertebraeoi the human spinal column is the cause of many ailments. Malposition of vertebrae produces abnormal pressure on various nerves, whereby the parts of the body served by that nerve respond as though aifected by a local ailment in that part of the body, whereas the actual cause of. the ails ment is the malposition of the vertebrae rather than a local ailment indicated by the nerve response.

Xo'ay examination and palpation have been the only methods of determining malposition of vertebrae. However, even these are not accurate, for much analysis left to the skill of the technician. X-ray analysis is not only dangerous because of the X-ray, but is slow and involves the taking of numerous pictures. An analysis by palpation is large y a matter of skill of the technician and much guesswork can be involved.

Many of the apparent ailments in local areas of the human body can be traced to the malposition of vertebrae in the cervical, thoracic, lumbar, sacrum or cocc x areas. In a normal, healthy person the vertebrae of the spinal column are all aligned along an imaginary median line that bisects the body from top to bottom. The vertebrae a l lay in parallel planes with the transverse processes or side projections in vertical arrangement. The spinous processes or rear rojections are also in vertical arrangement.

It is, therefore, an object of this invention to provide a method and apparatus by which an accurate analysis can be made of malposition of vertebrae to determine any angular misplace ment of any of the vertebrae about a vertical axis or to determine any lateral dispiacement, either sideways of the human body or forwardly or :rearwardly thereof vfrom a normal position, and which apparatus and method will give an immediate accurate result of indicating any such ma pcsition. After determination of any malposition of vertebrae, proper steps can taken to return the vertebrae to normal position in the spinal column.

Still another object of the invention is to provide a method and apparatus for indicating angular displacement of vertebrae relative to either a horizontal or vertical axis or any lateral displacement of vertebrae from a vertical axis by the transmission of audible signals through the spinal column, which will be reflected from the transverse processes or spinous process of the vertebrae or any other projection, to. permit comparison of signal intensity from opposite processes or projections of a vertebra under investigation, whereby to indicate accurately the vertical or horizontal angular position or lateral displacement of the vertebra relative to vertebrae on either side of the one under consideration.

Still another object of the invention is to provide a'method and apparatus for indicating accurately the angular misplacement or lateral disp' acement of. vertebrae by the use of a bubble level and a compass so arranged with respect to a pair of sound receivers, that are connected with a sound intensity indicating apparatus, that displacement of the sound receivers relative to' a vertebra under investigation will cause the sound signals to be received in the sound receivers of varying signal strength from the transverse or the spinous process to indicate the locations of the processes and therefore angular misplacement or lateral displacement of the vertebra, the bubble level indicating angular misplacement relative to a horizontal piane and the compass indicating angular misplacement about a vertical axis through the spinal column.

Further objects and advantages willbecorne apparent from the drawings and the followin description.

In the drawings:

Figure l is an elevational view illustrating the apparatus of this invention.

Figure 2 is an enarged cross-sectional View taken along line 2-2 of Figure 1.

Figure 3 is a perspective view of an auditory signal producing device.

Figures i and 5 are diagrammatic views illustrating the use of the apparatus of Figure l.

' Figure 6 is a cross-section taken along line 6-6 of Figure l.

Figure 7 is an elevational view of a right-angle sound receiver for investigating vertebrae in the thoracic, lumban'sacrurn or coccyx areas.

The sound receiving and indicating apparatus consists of a pair of sound receivers or listening posts in and H that are adapted for placement at opposite sides .of a vertebra that is under investigation, as for example the cervical vertebra .12.

The sound receivers it! and Ii may ly be enlargements at the end of sound transmittin tubes I3 and I4, respectively, or they may be individual cone-shaped devices, such as illustrated in Figure 2. Preferably, the sound receivers or listening-posts are adjustable on the tubes It and E i, respectively, for proper adjustment between them when placed against the neck or back of a patient, suitable ball-joints Ida and [la being provided to adjust the receivers on the contour of the neck of a patient, or as shown in Figure 7, a right-angle sound receiver may be provided for investigating fleshy areas of the back of a patient, a suitable ball-joint Eilia being provided to adjust the receiver 50 on the contour of the back of the patient.

The sound receiving tubes I3 and I4 are hollow so that the sound received by the receivers in and II can be transmitted through said tubes I3 and I4 to a sound-receiving apparatus I 5. The tubes I3 and I I are flexibly rigid in the usual manner of stethoscope tubes. Flexible tubes ISa and I411 connect to the tubes I3 and III respectively and join into a common flexible tube 55 that leads to a diaphragm 56 positioned adjacent the pick-up microphone I 6. The tubes can be held in adjusted position relative to each other by a link 5! that has the loops 58 engaging the serrations 59 on the tubes I3 and I l.

Sounds transmitted through either of the tubes I3 and [4 are picked up by a microphone I6 located in a soundproof compartment of an electronic amplifying apparatus I! which may be connected to a visual indicator meter IE3 or a loudspeaker I 9 for amplifying and indicating the intensity of the sound received through the tubes I 3 and I4 for comparison by the doctor.

A bubble level 20 is secured onto the tubes I 3 and I 4 in any suitable manner. The vial containing the liquid which forms the bubble 28a should have its longitudinal axis parallel to a common axis between the sound receivers Ill and IE, and the rotative axis of the bubble level 20 should be normal to the common axis between the sound receivers II] and II, whereby tilting of the sound receivers I0 and II relative to a horizontal plane will cause longitudinal movement of the bubble 20a in the bubble level to indicate the degree of angular displacement of the common axis between the sound receivers relative to a horizontal plane.

A compass 25 is also carried by the tubes is and I4 for the purpose of indicating the rotative position of the sound receivers relative to a vertical axis whereby to indicate the angular displacement of the common axis between the sound receivers about the vertical axis. The compass 25 has its axis of rotation normal to the common axis between the sound receivers It! and II and to the rotative axis of the bubble level 20.

The compass 25 may be carried in a bezel 255 for rotation to set the compass arrow 28 in an initial set position, pointing to N, whereafter rotation of the entire device in a horizontal plane will indicate angular deflection of the common axis between the sound receivers about a vertical axis.

It will thus be seen that if the detecting device shown in Figure 1 is held in a horizontal position, with the arrow of the compass initially set pointing toward the point N, and with the bubble in the bubble level centered longitudinally of the level, any deflection of the sound receivers I I and II, either about a horizontal axis or a vertical axis, will be indicated accurately by the bubble level 20 and the compass 25 as a result 4 of movement of the bubble in the level or the arrow of the compass.

To use the apparatus of this invention, it is necessary to produce a sound stimulus in the vertebral column of the human body. Thus, in Fig. 3, there is illustrated an auditory signalproducing device which consists of an electrically actuated vibrator 30 carried on an elastic belt or strap 3I. The belt 31 is made of elastic material so that it may stretch with normal body movements to maintain the signal producing device against the body with a uniform pressure and thereby prevent variation in intensity or signal strength transmitted to the bone like tissue of the body. Any device suitable for producing a vibration in the auditory range can be satisfactorily used.

The apparatus of this invention is adapted to establish the angular misplacement or lateral displacement of vertebrae from their normal position in the spinal column. For example, as shown in Figure 5, Atlas, represented by A, carries theskull C, and axis B carries Atlas A. The cervical vertebrae, as do all vertebrae, have transverse processes All and ll, as illustrated on Atlas A. When a vibration is referred to Atlas, the vibration will be distributed throughout its structure and therefore to its lateralmost tips or transverse processes. These transverse processes 46 and II approach both sides of the neck of the human body, as illustrated in Figure 1. All parts of any vertebra that are reasonably close to the surface afford points of examination. The lateral, or side, and posterior, or rear, parts of such vertebrae are available for this purpose whereas the anterior processes facing the front of the body and therefore its greater width, would be unavailable. The transverse processes, articulating surfaces, lamina, pedicles, spinous processes and in some cases the lateral portions of the body of vertebrae are intended to be points of consideration.

Thus, if the sound receivers I t and I I are positioned in the known location of the transverse processes of Atlas, vibration transmitted from the processes and II will be picked up by the sound receivers II} and I I and will be transmitted to the sound receiving apparatus It through the tubes l3 and I4 for indication of the intensity of the sound received by either the meter I8 or the loud speaker I9, or both.

The doctor in analyzing the position of the vertebrae will, for example, place the sound receivers II! and II at opposite sides of Atlas, A as shown in Figure 1. He will then pinch off either flexible tube Ida or I la with his fingers, or suitable clamps can be provided for this purpose, whereby to selectively stop the transmission of sound to the sound receiving apparatus from either of the sound receivers or listening-posts III and II.

By alternately pinching off the tubes Isa and Ida, and by viewing the meter IB or listening to the speaker I9, the doctor can determine the comparative intensity of sound received in the sound receivers or listening posts I0 and II, respectively.

At the start of an examination, of vertebrae in the neck area of the patient, which procedure is illustrated in Figure 1, the instrument is placed in the position shown in Figure 1 relative to the neck of the patient with the receivers or listening posts I0 and II disposed at opposite sides of the patients neck. The instrument is held so that the tubes I3 and I4, which are similar to stethoscope tubes, are disposed in a horizontal plane,

accepts 5 thus :positioning the :bubble 20a of the bubble level =20 in its mid lposition :intthe level, as illustrated in Figure and the compass .25 L-is :addusted so that the compass :arrow I28, win, for example, =-p0intt0 N."

'llhe doctor will then move the listening posts, for example, vertically up and down :on the *patieritsmecknr rotate the i'instrument on 1a :Ihori- Zontal axis that :extends through the patient's -neckwith thelistening posts to and 11 ithus-moving in the area of the assumed position :of the iprocess 1|, for example, and will also move the listening post "I l forward and backward over the patients neck by rotating the instrument on an axis ex'tending :vertically through the patients neck, at all times listen'ing to the sound received through the sound receiving apparatus t5, and watching the meter I8 to determine when the 'sound is received at its maximum intensity. When the maximum of intensity of sound is re- :ceived, as indicated by hearing the sound, or by visual inspection the meter l8, the doctor'will know that the listening post l l is in direct alignmentwith the process 41 since the maX-imumintensity of sound will be received only when the listenin post l'l is at its nearest position relative to the process '41.

The doctor will then hold the listening post l l stationary on the patients neck at the position at which the maximum intensity :of sound is received from the process 4! and will then move the sound receivenor listening post -l0 up and down over the patients neck and back and foi th and forward and backward over the same in the same manner as the listening post l I. At this time the doctor will pinch off tube l4'a so that *the sound will not be received through the *soundconduo'ting tube it, but rather sound will now be received through the tube l3. "When maximum intensityof sound is received "through the tube 1 3, the doctor will then know that the listening post it is at its nearest position adjacent process '10, thus establishing positive posiitions of the processes Ill and 41 in the patients body.

"If the vertebra I 2 'is in a normal position in thespinal column, the bubble 20a, of the level =20 --.w"i11 be at itscenter position as illustrated in Figure 1 and the arrow 28 of the compass 25w ill :be pointed :to.N, asthe instrument was initially positioned relative to the patients body. With the bubble 20a and 'thearrow 28 "in their normal positions, as at the start of the examination, "this will indicate to 'ithe doctor that the vertebra 12 is in tits normal position, :and there is :no misplacement of this vertebra relative to other vertebrae in the "spinal column in the patients body.

rHowever, if the bubble 20a has moved from its center position, as illustrated in Figure 1 toward either end of the bubble level 20, trthiswill immediatelyxindicate to the doctor that 'the vertebra 12 is misplaced :from .a direct horizontal :plane, which it "should normally assume, and the disposed in -atdirect horizontal plane.

Similarly, rafter dahe doctor has made his sex- ,ploratory :search as previously described Etc 10- lcate ithe :exact position of 313119 processes '40 and 4:1 byrlistening tolthe maximum intensity ofrs'ounfd received from these :processes as previously ade- -scribed, the doctor will also inspect the position of the arrow on thelcompass 25. If the arrow 28 is in .its normal position pointing toward N" at which it was set at the beginning of the examinationythe doctorwill know that the vertehra i2 is in its normal position relative to the median line that bisects the body from front to near, the processes 40 and M 'normally-beingpo- .sitioned at right angles to the line that bisects e :the human :body so that under normal condition 'ithefarrowizll'will point directly at the imaginary median line that bisects the human body.

l'HoWever, should the arrow 28 swing to either "side :of its initially set position, it will immediately indicate to the doctor that the vertebrae 12 has rotated on its:axis represented by the axis ,ofithe-spinal column. The degree of deflection of the arrow '28 to one side or the other of its initial position will indicate the degree of roration of the vertebra 12 about its vertical axes since "the :compass is marked off in degrees.

"The position of the transverse or side processes of "the 'ivertebra 12 can be compared with the transverse or side processes of the vertebra immediately above and below the vertebra l2 and readings taken of the bubble 20a and the compass 25 in accordance with the procedure described heretofore, so that a comparison can be made :of the :position of the transverse processes of the various vertebrae .one with the other to locate the vertebra that is malpositioned in the :spinal column.

Having found the vertebra that is malposiatione'd the doctor can then'proceed with manual manipulation to place the malpositioned 'vertebrainto'its correct :position and thus overcome the patients diflicult-y. The doctor having manipulated the ver tebra to what he believes to ibe the correctposition, can immediately check the results of his manipulation by again using the instrument in the manner heretofore described and comparing the position of thevertebra that has been manipulated with those above and below "it. This procedure can be followed until thever'tebra is placed into its correct position-relative to others in the spinal column.

It will of course be understood that if more than "one vertebrais malpositioned their position-can also be determined in the manner heretofore described and corrected by proper manual manipulation and the correction checked before the patient leaves the doctors office.

Since many of the normal elements of the human body can be traced to malpositioned vertebrae in the spinal column, the doctor, by the use of the instrument of this invention, will be enabled to insure correct positioning of the vertebrae before the patient leaves his office rather than following the existing practice of making a manual manipulation correction by mere feel and then waiting for the patient to report on his physical condition several days later.

'The sound stimulus for transmission to the vertebral column can be produced in any bone having continuity, either direct or indirect, with the spinal column. Thus, in Figure 4 the auditory signalproducing device 3'!) "is illustrated as being ap-plied to the'body directly at the spinal column. However, the sound "stimulus can be 7 produced in the spinal column by placing the signal device 30 at the sternum or breast-bone, and in this instance the added advantage will be had that the vibration will be amplified by the thoracic cavity and its contents.

While the invention has been heretofore described with reference to the investigation of vertebrae in the cervical area, yet the vertebrae in the thoracic, lumbar, sacral and coccygeal areas can also be investigated. In this instance, the right angular sound receiver 58, illustrated in Fig. '2, is substituted for each of the sound receivers it and i l illustrated in Figure 1. Thus, the sound receivers Will both point in the same direction toward the patient on parallel axes that are normal to the region of the back of the patient.

There are conditions under which the vertebra i2 is malpositioned merely in a sidewise direction rather than being misplaced angularly relative to a horizontal plane or rotative about the axis of the vertebra hereinbeforedescribed.

Under these conditions examination of the vertebra S2 in the manner hereinbefore described will cause the instrument to assume the position illustrated in Figure l with the bubble Zea at its normal mid position and with the compass arrow 28 at its normal position pointing at N. Under this condition the doctor will note that the bubble level and compass are both in their normal positions, but under the condition wherein the vertebra i2 has merely moved directly in sidewise direction either left or right of the patients neck, process il, for

example, will be closer to the listening post H than the process it is to the listening post ill, assuming the vertebra l2 has side-slipped in a rightward position as viewed in Figure 1. Under this condition the sound received through the sound conductor M will be of a greater intensity than the sound transmitted through the sound conductor E3. the doctor alternately pinching off tubes Ma. and 53a to compare the intensity of sound received through the tubes is and i3 respectively. The greater intensity of sound received through the tube i indicates to the doctor that the vertebra I2 has side-slipped in a rightward direction as viewed in Figure 1 but is in its normal horizontal position since the bubble of the bubble level 28 andthe arrow of the compass are in their normal position. Having found this condition existing the doctor can manipulate the vertebra in the leftward direction to place it in its correct position in the spinal column and then check his manipulation by again comparing the sound intensity that is received from the processes ii} and 45. When the intensity of the sound received through the tubes it and i as alternately compared, is of equal value the doctor will know that he has manipulated the vertebra i2 to its correct position centralized with other vertebrae in the spinal column.

In the region of the-back of a patient, from the shoulder to the hip area, that is in the thoracic, lumbar, sacral and coccygeal areas, it will be obvious that placement of the sound receivers lo and H at the left and right sides of a patients body would place the sound receivers too distant from the processes of the spinal column to receive a satisfactory sound stimulus. Thus, to investigate the individual vertebra in the spinal column in the region of the backof apatient, the sound receivers iii and ii are re-' placed with a sound receiver such as that indicated in Figure 7 so that the sound receiver 50 the sound receiving openings of the sound receivers both pointed in the same direction so that they can both be placed against the back of a patient simultaneously. The sound receivers on the tubes l3 and [4 will at this time be placed at opposite sides of the imaginary median line that bisects the human body so that one sound receiver will be adjacent the transverse processes on the left side of the vertebra and the other sound receiver will be adjacent the transverse processes on the right side of the vertebra.

At the start of an investigation of the suspected malpositioned vertebra in the spinal column in the area of the back of a patient, the sound receivers 5% will be placed against the backof the patient in the manner heretofore described and the instrument will be leveled to a horizontal plane so that the bubble 26a of the bubble level is will be disposed in its mid position as illustrated in Figure 1. The compass arrow 28 will be positionedso that it points at N, and also will .be in direct alignmentiwith the imaginary median line that bisects the human body from front to rear, thus pointing immediately at the center of the back of a patient.

With the instrument so positioned, the doctor will pinch off tubes Eta and Ma alternately to listen to the intensity of sound received from the transverse processes of the vertebra under investigation. If the intensity of sound received from each of the transverse or side processes of the vertebra is identical, and the bubble 28a remains in its mid position and the compass arrow 28 remains pointed at the center of the back of a patient, the doctor will know that the vertebra under investigation is in its pro-per position laterall of the patients body.

.However, if the sound stimulus received from the transverse processes should be dissimilar, the doctor can then move the instrument to the right or to the left of the patients body until identical stimulus is received from'each of the transverse processes of the vertebra under investigation. The degree of movement to the right or left of a patients body would indicate the degree of lateral slip of the vertebra that is under investigation. This can be noted by the fact that the compass arrow will no longer be pointed in the immediate center of the patients back, and the amount that it is to the left'or right of the center of the patients back will indicate the amount of side-slip of the vertebra to either left or right.

Further, if the sound stimuli received from each of the transverse processes of the vertebrae under investigation in the back area of the patient are not the same when the instrument is ina horizontal position with the arrow 28 of the compass pointed at the center of the patients back, the doctor can also investigate whether the vertebra under investigation is misplaced angularly from a horizontal plane by moving the sound receivers up and down over the patients back until the sound stimulus received through each of the sound receivers 50 is identical. The angular displa'cementof the instrumentfrom a direct horizontal plane will 9 e nd cat d b e po i ion o he bubble. 2. 11 of the bubble level; 20; bymOVillgeither to left or right of its mid position, and the degree, of; angular displacement will .be indicated by the degree of the movement of the bubble from its mid position.

Having made an instrument determination of; the malpositioned vertebra, the doctor can then manually manipulate the vertebra to, return it to its normal position, and then can check the manual manipulation by again determining the position of the processes in the manner here-. tofore described. This process can be repeated until full correction is made.

While the method and apparatus disclosed: and described herein illustrate a preferred form ofinvention, yet it will be understood that media fications can be made Without departing from, the. spirit of the invention, and that modifications that fall within the scope of the appended claims are intended to, be included herein.

Having thus fully described m invention, What I claim as new and desire to Secure by Let-n ters Patent is:

1. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair of sound receivers, mechanism for indicating rotative positions of said sound receivers relative to a vertical and a horizontal: axis and including means fixedly connecting said sound receivers with said mechanism, means for conducting an auditory signal from said sound receive-rs, and indicatingmeans operatively connected with said conducting means to indicate the intensityof the auditory signals conducted by said conducting means.

2. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair or sound receivers, apparatus for indicating the rotative positions of; said sound receivers relative to a vertical and a horizontal axis, means for conductin an auditory signal from said sound receivers, and electrical apparatus o era i e con e ed w th a d onductin pm.co ndic ti h tensity ilthe audiorr chi al-v A pa atus fo de mini m n si ion, or h v r e f th v rt b a olumn. hc u n a pair of sound receivers, a level connected with Said sound receivers for indicating the rotative position of said receivers relative, to a horizontal axi encom as operatively o t d w h ai sound receivers for ndicating the rotative position of said receivers relative to a vertical axis, means for conducting an auditory signal from said sound receivers, and means connected with said conducting means iorindicating the intensity of the auditory signal conducted by the said conducting means.

4. Apparatus for determining malposition of a vertebra of, the vertebral column including, a P il .0111101 receiving ub s QQ h tfid tQ fillhfi f at a common juncture and having their sound rece vin ds tio e n mm ane: nd.

equidistant from the said juncture, a. lev lv in,-

heat n a r us ohcrativ v o e t with,

nd catin e in n ity f he a d o y" si nal received tromthe u d receivers p ara u for det rmi n ma rositi h o a vertebra of the vertebral, column including, a pair of sound receiving tubes connected together at a m un and; havin he sound receiving n s P it ed n a compo, lane d quidista t fr m the sa d ct re, a, eve indicating apparatus. operatively connected with ai s n ec ivers, for indi tin t e osition thereof relative to a true horizontal; plane, a 5.8.0:: 0nd indicating apparatus operatively connected with said sound receivers. for indicating the rota: tive position, thereof; about a. vertical axis, means, for controllable conduction of; an. auditory. signal from each of said sound receiving tubes, and means. operatively connected with said conduct: ing means for'indicating the intensity of' the auditory signal received from the sound'receivers.

6. Apparatus for determining malposition of a vertebra of the vertebral column including, a. pair of sound receiving tubes connected together at a common juncture and having their soundreceiving ends positioned in a common plane and equidistant from the said juncture, a levelindi-, cating apparatus operatively connected with said sound receivers for indicating the position thereof relative to a true horizontal plane a second indicating apparatus operatively connectedwith said sound receivers for indicating the rotative position thereofabout a vertical axis, means for separate controlled conduction of an auditory signal from each of said sound receiving tubes, and means operatively connected with said conducting meansfor indicating the inten sity of the auditory signal received from the sound receivers.

'7. Apparatus for determining malposition or a vertebra of the vertebral column including, a pair of rigid sound receiving tubes adjustable relative to each other connected together at a common juncture and having their sound receiving ends positioned in a common plane and equidistant from the said juncture, mechanism for indicating rotative positions of said tubes about a horizontal axis anda vertical axis, means connecting said mechanism with said sound recaving tu r s lish th P sin th reof relative to a horizontal and vertical indicating axis of the said indicating mechanism, ine ans for on in au i r ie a m were r n d h 'msan Qheratiy l n: h a h i onduc n means to r c one the ud or e r -1 there rom and indat ce the intensity thereof,

8. Apparatus for determining malp osition, or a vertebra of the vertebral column including, a pair of rigid sound receivin tubes flexibly ar; ranged and connected together at a common. juncture and having their sound receiving positioned in a common plane and equidistant m t d nctu e, m an c ectin l evel,

ca g e ce With sai ube to indica the degree of angular change of said common plane relative to the horizontal, a second indicating device for indicating rotative positionsfoi tubes about a vertical axis operatively connected with said tubes, with the of the said second device normal to said common plane. oisaid tubes, whereby to indicate. the rotativeposition of said tubes about a vertical axis passing through said common plane, means tor cont M lable conduction of an auditory signal n e o s t es, an ppara us hr ace ,1. t.

i l auditory signals from said tubes to indicate the intensity thereof relative to each other.

9. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair of rigid sound receiving tubes flexibly arranged and connected together at a common juncture and having their sound receiving ends positioned in a common plane and equidistant from the said juncture, means connecting a level indicating device with said tubes to indicate the degree of angular change of said common plane relative to the horizontal, a second indicating device for indicating rotative positions of said tubes about a vertical axis operatively connected with said tubes, means for controllabl conduction of an auditory signal from each of said tubes, and apparatus for receiving the auditory signals from said tubes to indicate the intensity thereof relative to each other.

10. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair of rigid auditory signal transmitting tubes adjustable relative to each Other and connected together at a common juncture, a sound receiver positioned at the end of each of said tubes positioned in a common plane and equidistant from said juncture, a level indicating device carried by said tubes with the rotative indicating axis thereof positioned parallel to said plane, a second indicating apparatus carried by said tubes operatively connected with said tubes for indicating the rotative position thereof about a hori zontal axis, and means for conducting an auditor signal from said tubes.

12. Apparatus for determining malposition of a vertebr of the vertebral column including, a pair of sound receiving tubes connected together at a common juncture and having their sound r receiving ends positioned in a common plane and equidistant from the said juncture, a bubble level operatively connected with said tubes for indicating the rotative position thereof about a horizontal axis, and controllable means for conducting separately an auditory signal from each of said tubes.

13. Apparatus for determining malposition of the vertebra of the vertebral column including, a pair of sound receivers, a level connected with said sound receivers for indicatin the rotative position of said receivers relative to a horizontal axis, a compass operatively connected with said sound receivers for indicating the rotative position of said receivers relative to a vertical axis, and means for conducting an auditory signal from each of said sound receivers 14. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair of sound receivers positioned on a common axis, mechanism for indicating rotative positions of said receivers about a horizontal axis and a vertical axis, rigid means connecting said mechanism with said sound receivers to position the common axis normal to the horizontal and veri2 tical indicating axes of the said indicatin mech-' anism, and meansfor conducting auditory signals from said sound receivers. v

15. Apparatus for determining malposition of a vertebra of the vertebral column including, a pair of sound receivers, apparatus for indicating rotative positions of said sound receivers relative to a vertical and a horizontal axis and including means connecting said sound receivers thereto, means for conducting an auditory signal from said sound receivers, indicating means operatively connected with said conducting means to indicate the intensity of the auditory signals conducted by said conducting means, and a signal producing device for operative association with said sound receivers for establishing an auditory sound adapted to be picked up by said receivers.

16, Apparatus for determining malposition of the vertebrae of the vertebral column including, a pair of sound receivers, a level connected with said sound receivers for indicating the rotative position of said receivers relative to a horizontal axis, a compass operatively connected with said sound receivers for indicating the rotative position of said receivers relative to a vertical axis, means for conducting an auditory signal from said sound receivers, means connected with said conducting means for indicating the intensity of the auditory signal conducted by the said conducting means, and a signal producing device having flexible means for removably attaching the same to a human body for operative association with said sound receivers for establishing an auditory sound adapted to be picked up by said receivers.

17. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body of sufiicient intensity for transmission of the signal through the vertebral column, establishing listening posts adjacent similar and opposite paired points of the osseous tissue to be investigated whereby to receive the auditory signal therefrom, and comparing the intensity of the auditory signal received from each of the paired points of the osseous tissue under investigation whereby to establish malposition of the same.

18. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body of sufficient intensity for transmission of the signal through the vertebral column, establishing listening posts adjacent opposite paired points on vertebrae to be investigated whereby to receive th auditory signal therefrom, and comparing the intensity of the auditory signal received from each of the said points of the vertebrae under investigation whereby to establish the malposition of the vertebrae.

19. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body of sufiicient intensity for transmission of the signal through the vertebral column, establishing listening posts adjacent similar and opposite processes of the vertebrae to be investigated whereby to receive the auditory signal therefrom, adjusting the listening posts anteriorly and posteriorly of the vertebral column and comparing the intensity of the auditory signal from each of the processes of the vertebrae under investigation whereby to establish anterior or posterior malposition of the vertebrae or of their processes.

20. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body ofsufficient'intensity for transmission of the signal through the vertebral column, establishing listening posts adjacent similar and opposite processes of the vertebrae to be investigated; whe einv o r ceive. the audito y si f om, ad ust n the listen n post inferior and s nerior of the Ver ebral. c lumn and compe nathei tcnsity oi the audit y s n m a r the transverse. pr cesses of the. vertebrae unde investigation whereby to establish inferior or superior malposition of the vertebrae or of their processes.

21. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body of sufiicient intensity for transmission of the signal through the vertebral column, establishing listening posts adjacent similar and opposite processes of the vertebrae to be investigated whereby to receive the auditory signal therefrom, receiving separately the auditory signal from each of opposite processes and comparing the intensity or the auditory signal from each of the processes of the vertebrae under investigation whereby to establish lateral malposition of the vertebrae relative to the median line of the human body.

22. The method of determining malposition of vertebrae of the vertebral column particularly in the cervical area comprising, applying an auditory signal to the vertebral column of suiiicient intensity for transmission of the signal therethrough, establishing listening posts adjacent similar and opposite paired parts of the vertebrae to be investigated whereby to receive the auditory signal therefrom, adjusting the listening posts superiorly and inferiorly of the vertebral column and comparing the intensity of the auditory signal from each of the paired parts of the vertebrae under investigation whereby to establish superior or inferior malposition of the vertebrae.

23. The method of determining malposition of vertebrae of the vertebral column particularly in the cervical area comprising, applying an auditory signal to the vertebral column of sufiicient intensity for transmission of the signal therethrough, establishing listening posts adjacent opposite transverse processes of the vertebrae to be investigated whereby to receive the auditory signal therefrom, adjusting the listening posts superiorly and inieriorly from an anterior or posterior position of a transverse process of a vertebra under investigation in the vertebral column and comparing the intensity of the auditory signal from each of the transverse processes of the vertebrae whereby to establish superior or inferior malposition of the vertebrae in the anterior or posterior malposition of the transverse process of the vertebrae.

24. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the vertebral column of sufiicient intensity for transmission of the signal therethrough, establishing listening posts adjacent similar and opposite processes or paired parts of the vertebra to be investigated whereby to receive the auditory signal therefrom, and comparing the intensity of the auditory signal from each of the said processes or paired parts of the vertebra under investigation whereby to establish angular and/or lateral malposition of the vertebra.

25, The. method of determining malposition of vertebrae oi the vertebral column comprising, applying an auditory signal to the human, body of sufficient intensity for transmission oi; the sig-r. nal through the vertebral column, establishing a listening, post adjacent processes of thever-te-i brae to, bev investigated selectively whereby to receive selectively the auditory signal therefrom, establishing a connection from the listening post to a level indicating device whereby tomove the level indicating device concurrently with, the 1 15!, tening post, and adjusting the listening post superiorly and inferiorlyi relative to the processes of a vertebra under investigation and selectively comparing the intensity of the auditory signal from the processes until substantial uniformity of intensity of signal strength is received from each of the processes whereby to establish the degree of superiority or inferiority of the processes of the vertebrae relative to a horizontal axis.

26. The method of determining malposition of vertebrae of the vertebral column comprising, applying an auditory signal to the human body of sufficient intensity for transmission of the signal through the vertebral column, establishing a listening post adjacent processes of the vertebra to be investigated selectively whereby to receive the auditory signal therefrom, establishing a connection from the listening post to a compass-type indicating device whereby to move the compass type indicating device concurrently with the listening post, and adjusting the listening post transversely of the processes of a vertebra under investigation and comparing the intensity of the auditory signal selectively from each of the processes until substantial uniformity of intensity of signal strength is received from each of the processes whereby to establish the degree of malposition of the processes of the vertebrae relative to the vertical axis of the vertebral column.

27. The method of determining malposition of vertebrae of the vertebral column particularly in the cervical area comprising, applying an auditory signal to the vertebral column of sufiicient intensity for transmission of the signal therethrough, establishing listening posts adjacent similar and opposite processes of the vertebrae to be investigated whereby to receive the auditory signal therefrom, transmitting the auditory signal from each of the said processes of the vertebrae to an i ndicating apparatus whereby to indicate the intensity of the auditory signal received from each of the said processes of the vertebrae, adjusting the listening posts relative to the said processes of the vertebrae and comparing the intensity of the auditory signal received from each of the points of examination until the signal strength received from each of the processes is substantially the same whereby to position the listening posts in axial alignment with the said processes of the vertebrae and to establish malposition of the vertebrae.

28. The method of determining malposition of the vertebral column particularly in the cervical area comprising, applying an auditory signal to the vertebral column of sufficient intensity for transmission of the signal therethrough, establishing listening posts adjacent opposite paired processes of the vertebrae to be investigated whereby to receive the auditory signal therefrom, transmitting the auditory signal from each of said processes of the vertebrae to an electronically controlled visual indicating meter whereby t6 indicate visually the intensity of the auditory signal received from each of the examined processes of the vertebrae, adjusting the listening posts relative to the said processes of the vertebrae, and comparing the intensity of the auditory signal received from each of the paired processes until the signal strength received from each of the said processes is substantially the same whereby to position the listening posts in axial alignment with the said processes of i the vertebrae to establish malposition of the vertebrae.

HERBERT J. HORNER.

16 REFERENCES o'ITEfi The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 1,552,284 Evins Sept. 1, 1925 1,648,899 Hayman Nov. 15, 1927 1,648,939 Evins Nov. 15, 1927 2,008,295 Smith July 16, 1935 2,161,370 Mears June 6, 1939 

